New Options for Preoperative Anesthesia in Intrauterine Needling
Status:
Completed
Trial end date:
2007-12-01
Target enrollment:
Participant gender:
Summary
The concept of fetal pain is becoming increasingly relevant due to growing possibilities for
invasive intrauterine treatment. There is much debate as to whether the fetus is mature
enough to be able to perceive pain at all. Recent studies have suggested that the fetus is at
least capable of exhibiting a stress response to intrauterine needling. Intrauterine
transfusions are most commonly performed by inserting a needle either in the umbilical cord
root at the placental surface, or in the intrahepatic portion of the umbilical vein of the
fetus. Recently, intrauterine needling in the intrahepatic vein has been shown to result in
alterations in fetal stress hormones, which has been interpreted as a reaction to pain. These
changes were not observed in intrauterine needling in the umbilical cord root, or after
administration of analgesics to the fetus. The investigators tested the hypothesis that
remifentanil provides fetal analgesia, assessed by a reduced fetal stress response. The
investigators performed a randomised controlled trial comparing fetal stress response between
patients undergoing intrauterine transfusions for alloimmune fetal anemia receiving
remifentanil, or placebo.